Page 13 - Altered Obstructive Nursing Care
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Nursing Interventions Rationale
Reduces the risk of improper use and
Devise system for recording prescribed overdosage of prn medications, especially
intermittent drug and inhaler usage. during acute exacerbations, when cognition
may be impaired.
Although the patient may be nervous and feel
the need for sedatives, these can depress
Recommend avoidance of sedative antianxiety respiratory drive and protective cough
agents unless specifically prescribed or
approved by the physician treating a mechanisms. Note: These drugs may be used
prophylactically when the patient is unable to
respiratory condition.
avoid situations known to increase stress or
trigger respiratory response.
Review oxygen requirements and dosage for a Reduces risk of misuse (too little or too much)
patient who is discharged on supplemental and resultant complications. Promotes
oxygen. Discuss safe use of oxygen and refer environmental and physical safety.
to the supplier as indicated.
Instruct patient and SO in use of Nasal Nasal intermittent positive pressure
intermittent positive pressure ventilation (NIPPV) may be used at night or
ventilation (NIPPV) as appropriate. Problem- periodically during the day to decrease
solve possible side effects and identify adverse CO2 level, improve quality of sleep, and enhance
signs and symptoms (increased dyspnea, functional level during the day. Signs of
fatigue, daytime drowsiness, or headaches on increasing CO2 level indicate the need for more
awakening). aggressive therapy.
These patients and their SOs may experience
anxiety, depression, and other reactions as they
Provide information and encourage deal with a chronic disease that has an impact
participation in support groups (American on their desired lifestyle. Support groups
Lung Association, public health department). or home visits may be desired or needed to
provide assistance, emotional support, and
respite care.
Refer for evaluation of home care if
indicated. Provide a detailed plan of care and Provides for continuity of care. May help reduce
baseline physical assessment to home care the frequency of rehospitalization.
nurse as needed on discharge from acute care.
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